medigraphic.com
SPANISH

Revista Cubana de Medicina Tropical

ISSN 1561-3054 (Electronic)
  • Contents
  • View Archive
  • Information
    • General Information        
    • Directory
  • Publish
    • Instructions for authors        
  • medigraphic.com
    • Home
    • Journals index            
    • Register / Login
  • Mi perfil

2021, Number 3

<< Back Next >>

Rev Cubana Med Trop 2021; 73 (3)

Effectiveness and safety of antiretrovirals for switch therapy in human immunodeficiency virus

Millán VIC, Romero SD, Estrada-Orozco K
Full text How to cite this article

Language: Spanish
References: 28
Page: 1-19
PDF size: 535.44 Kb.


Key words:

immunodeficiency syndrome, acquired immunodeficiency syndrome, HIV-1, antiretrovirals, highly active antiretroviral therapy.

ABSTRACT

Introduction: Increase in the life expectancy of people living with HIV has led to the search for simplified antiretroviral therapy alternatives of lower toxicity potential which foster adherence and thus contribute to achieve viral load undetectability goals. Several options have been proposed in recent years, and it is necessary to be aware of their mid- and long-term effectiveness.
Objective: Determine the effectiveness and safety of switch therapy in patients aged over 12 years who live with the human immunodeficiency virus.
Methods: A bibliographic search was conducted in electronic databases and the gray literature. Combined estimation was made of the measure of outcomes for viral load maintenance (less than 50 copies per milliliter), CD4+ T lymphocyte levels and adverse events of switch therapy versus continuing standard therapy.
Results: Six randomized clinical trials were included which compared switch therapy (rilpivirine / emtricitabine / tenofovir alafenamide, dolutegravir / rilpivirine, abacavir / dolutegravir / lamivudine) with continuing standard therapy. Viral load maintenance was not different between the groups (OR: 0.77; CI 95% 0.59, 1.02), nor was there any difference in the CD4+ T lymphocyte count (DME: 6.76; CI 95% -5.05;18.57) or the serious adverse events (OR: 1.03; CI 95% 0.74; 1.42).
Conclusions: Differences were not found in the effectiveness and safety of switch therapy versus continuing standard therapy. Results support the use of these therapeutic strategies to foster adherence to antiretroviral therapy.


REFERENCES

  1. InfoSIDA. Afecciones relacionadas con el VIH / SIDA ¿Qué es una infección oportunista? [Internet]. 2019 p. 1-4. [acceso: 01/05/2020]. Available from: Available from: https://hivinfo.nih.gov/es/understanding-hiv/fact-sheets/que-es-una-infeccion-oportunista

  2. Shaw GM, Hunter E. HIV transmission. HIV AIDS A Found Nurs Healthc Pract. 2003;32-42..

  3. HIV Prevention [Internet]. [access: 19/05/2020]. Available from: Available from: www.cdc.gov/hiv/basics/prevention.html

  4. Centers for Disease Control and Prevention. Morbidity and Mortality. Weekly Report - Sexually Transmitted Diseases Treatment Guidelines. 2015 [access: 19/05/2020];51:199. Available from: Available from: https://www.cdc.gov/mmwr/preview/mmwrhtml/rr6403a1.htm

  5. ONUSIDA. Hoja informativa - Últimas estadísticas sobre el estado de la epidemia de sida | ONUSIDA. [Internet]. 2019. p. 2018-20. [access: 05/05/2020]. Available from: Available from: https://www.unaids.org/es/resources/fact-sheet

  6. Departamento de Salud y Servicios Humanos. Tratamiento para la infección por el VIH [Internet]. infoSIDA. 2019 p. 1-4. [access: 20/11/2020]. Available from: Available from: https://infosida.nih.gov/understanding-hiv-aids/fact-sheets/21/51/tratamiento-para-la-infeccion-por-el-vih--conceptos-basicos

  7. Mateo-Urdiales A, Johnson S, Smith R, Nachega JB, Eshun-Wilson I. Rapid initiation of antiretroviral therapy for people living with HIV. Cochrane Database Syst Rev. 2019; 2019 (6).

  8. Iwuji C, Orne-Gliemann J, Balestre E, Larmarange J, Thiebaut R, Okesola N, et al. The impact of universal test and treat on HIV incidence in a rural South African population: ANRS 12249 TasP trial, 2012-2016. Aids[Internet]. 2016 [access: 19/05/2020]:2-4. Available from: Available from: http://programme.aids2016.org/Abstract/Abstract/10537

  9. WHO. HIV/AIDS - Treatment and care [Internet] 2007. [access: 15/05/2020]. Available from: Available from: https://www.who.int/hiv/topics/treatment/en/

  10. McCreesh N, Andrianakis I, Nsubuga RN, Strong M, Vernon I, McKinley TJ, et al. Universal test, treat, and keep: Improving ART retention is key in cost-effective HIV control in uganda. BMC Infect Dis [Internet]. 2017 [access: 19/05/2020];17(1):1-11. Available from: Available from: https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-017-2420-y

  11. Cabrera S. Terapia Antirretroviral: cambios por toxicidad o simplificación (sin fracaso) [Internet]. 2017. p. 1-20. [access: 19/05/2020] Available from: Available from: http://www.infectologia.edu.uy/images/archivos/Terapia_Aantirretroviral_Julio2017.pdf

  12. Julian Higgins JT. Cochrane Handbook for Systematic Reviews of Interventions [Internet]. 2019 [access: 15/11/2020]. Available from: Available from: https://training.cochrane.org/handbook/current

  13. Urrutia G, Bonfill X. Declaración PRISMA [Internet]. Vol. 135, Medicina Clínica. 2010. p. 507-11. [access: 19/05/2020] Available from: Available from: http://es.cochrane.org/sites/es.cochrane.org/files/public/uploads/PRISMA_Spanish.pdf

  14. McMaster University. GradePro Guideline Development Tool [Internet]. 2020 [access: 20/01/2020]. Available from: Available from: https://gradepro.org/

  15. Hagins D, Orkin C, Daar ES, Mills A, Brinson C, DeJesus E, et al. Switching to coformulated rilpivirine (RPV), emtricitabine (FTC) and tenofovir alafenamide from either RPV, FTC and tenofovir disoproxil fumarate (TDF) or efavirenz, FTC and TDF: 96-week results from two randomized clinical trials. HIV Med [Internet]. 2018 Nov[access: 19/05/2020];19(10):724-33. Available from: Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6221083/

  16. DeJesus E, Ramgopal M, Crofoot G, Ruane P, LaMarca A, Mills A, et al. Switching from efavirenz, emtricitabine, and tenofovir disoproxil fumarate to tenofovir alafenamide coformulated with rilpivirine and emtricitabine in virally suppressed adults with HIV-1 infection: a randomised, double-blind, multicentre, phase 3b, non-i. Lancet HIV[Internet]. 2017 May[access: 19/05/2020];4(5):e205-13. Available from: Available from: https://www.thelancet.com/journals/lanhiv/article/PIIS2352-3018(17)30032-2/fulltext

  17. Orkin C, DeJesus E, Ramgopal M, Crofoot G, Ruane P, LaMarca A, et al. Switching from tenofovir disoproxil fumarate to tenofovir alafenamide coformulated with rilpivirine and emtricitabine in virally suppressed adults with HIV-1 infection: a randomised, double-blind, multicentre, phase 3b, non-inferiority study. Lancet HIV. 2017;4(5):e195-204.

  18. Aboud M, Orkin C, Podzamczer D, Bogner JR, Baker D, Khuong-Josses MA, et al. Efficacy and safety of dolutegravir-rilpivirine for maintenance of virological suppression in adults with HIV-1: 100-week data from the randomised, open-label, phase 3 SWORD-1 and SWORD-2 studies. Lancet HIV [Internet]. 2019;6(9):e576-87. Doi: http://dx.doi.org/10.1016/S2352-3018(19)30149-3

  19. Trottier B, Lake JE, Logue K, Brinson C, Santiago L, Brennan C, et al. Dolutegravir/abacavir/lamivudine versus current ART in virally suppressed patients (STRIIVING): a 48-week, randomized, non-inferiority, open-label, Phase IIIb study. Antivir Ther[Internet]. 2017 [access: 19/05/2020];22(4):295-305. Available from: Available from: https://www.intmedpress.com/journals/avt/article.cfm?id=3166&pid=48&sType=AVT

  20. Arribas JR, Pialoux G, Gathe J, Di Perri G, Reynes J, Tebas P, et al. Simplification to coformulated elvitegravir, cobicistat, emtricitabine, and tenofovir versus continuation of ritonavir-boosted protease inhibitor with emtricitabine and tenofovir in adults with virologically suppressed HIV (STRATEGY-PI): 48 week results o. Lancet Infect Dis [Internet]. 2014;14(7):581-9. Doi: http://dx.doi.org/10.1016/S1473-3099(14)70782-0

  21. Campo RE, Cohen C, Grimm K, Shangguan T, Maa J, Seekins D. Switch from protease inhibitor- to efavirenz-based antiretroviral therapy improves quality of life, treatment satisfaction and adherence with low rates of virological failure in virologically suppressed patients. Int J STD AIDS [Internet]. 2010 Mar;21(3):166-71. Doi: https://doi.org/10.1258/ijsa.2009.008487

  22. Pozniak A, Markowitz M, Mills A, Stellbrink HJ, Antela A, Domingo P, et al. Switching to coformulated elvitegravir, cobicistat, emtricitabine, and tenofovir versus continuation of non-nucleoside reverse transcriptase inhibitor with emtricitabine and tenofovir in virologically suppressed adults with HIV (STRATEGY-NNRTI): 48 week r. Lancet Infect Dis [Internet]. 2014;14(7):590-9. Doi: http://dx.doi.org/10.1016/S1473-3099(14)70796-0

  23. Baril J, Conway B, Giguère P, Ferko N, Hollmann S, Angel JB. A meta-analysis of the efficacy and safety of unboosted atazanavir compared with ritonavir-boosted protease inhibitor maintenance therapy in HIV-infected adults with established virological suppression after induction. HIV Med [Internet]. 2014;15(5):301-10. Doi: https://doi.org/10.1111/hiv.12118

  24. Campo R, DeJesus E, Bredeek UF, Henry K, Khanlou H, Logue K, et al. SWIFT: Prospective 48-week study to evaluate efficacy and safety of switching to emtricitabine/tenofovir from lamivudine/abacavir in virologically suppressed hiv-1 infected patients on a boosted protease inhibitor containing antiretroviral regimen. Clin Infect Dis. 2013;56(11):1637-45.

  25. Cruciani M, Mengoli C, Serpelloni G, Parisi SG, Malena M, Bosco O. Abacavir-based triple nucleoside regimens for maintenance therapy in patients with HIV. Cochrane database Syst Rev [Internet]. Jun 2013 [access: 19/05/2020];(6):CD008270. Available from: Available from: https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD008270.pub2/full

  26. ONUSIDA. Un ambicioso objetivo de tratamiento para contribuir al fin de la epidemia de sida [Internet]. Unaids.Org. 2013. p. 39. [access: 05/05/2020]. Available from: Available from: https://www.unaids.org/sites/default/files/media_asset/90_90_90_es.pdf

  27. Organización Mundial de la Salud. Estrategia Mundial Del Sector De La Salud Contra El Vih 2016-2021 Hacia El Fin Del Sida. OMS [Internet]. 2016. p. 1-59. [access: 19/05/2020] Available from: Available from: https://apps.who.int/iris/bitstream/handle/10665/250574/WHO-HIV-2016.05-spa.pdf;jsessionid=F55585494601D2837BDD489C605C7496?sequence=1

  28. Fabbiani M, Mondi A, Colafigli M, D'ettorre G, Paoletti F, D'avino A, et al. Safety and efficacy of treatment switch to raltegravir plus tenofovir/emtricitabine or abacavir/lamivudine in patients with optimal virological control: 48-week results from a randomized pilot study (Raltegravir Switch for Toxicity or Adverse Events, RAST. Scand J Infect Dis [Internet]. 2014 [access: 19/05/2020];46(1):34-45. Available from: Available from: https://www.tandfonline.com/doi/abs/10.3109/00365548.2013.840920?journalCode=infd19




2020     |     www.medigraphic.com

Mi perfil

C?MO CITAR (Vancouver)

Rev Cubana Med Trop. 2021;73